中国医药指南
中國醫藥指南
중국의약지남
CHINA MEDICINE GUIDE
2013年
5期
14-16
,共3页
食管癌%吻合口瘘%原因分析%对策%呼吸衰竭%营养不良
食管癌%吻閤口瘺%原因分析%對策%呼吸衰竭%營養不良
식관암%문합구루%원인분석%대책%호흡쇠갈%영양불량
Esophageal carcinoma%Anastomotic leakage%Reason analysis%Countermeasure%Respiratory failure%Malnutrition
目的：探讨老年食管癌切除术后胸内吻合口瘘的原因分析及合理治疗方法。方法回顾我院自2000年1月至2009年12月对65例老年食管癌行左胸切口切除，胸内吻合术，术后并发胸内吻合口瘘4例，根据患者不同临床表现、胸片、B超及胸部CT结果选择治疗方法，2例行手术治疗，2例保守治疗。对治疗结果进行回顾性分析。结果全组共发生胸内吻合口瘘4例，发生率为6.1%，行保守治疗2例，死亡1例。行二次手术2例，死亡1例。病死率为50%。结论①老年食管癌术前应充分评估，严格掌握手术适应证，加强围手术期管理。②胸内吻合口瘘是食管癌术后严重的并发症和主要死亡原因。③早期诊断、恰当选择治疗方法能提高胸内吻合口瘘的疗效。④手术方法的改进和吻合技术的提高，有助于预防吻合口瘘；⑤积极应用TPN支持和胃肠内营养支持是处理胸内吻合口瘘的有效治疗方法。
目的：探討老年食管癌切除術後胸內吻閤口瘺的原因分析及閤理治療方法。方法迴顧我院自2000年1月至2009年12月對65例老年食管癌行左胸切口切除，胸內吻閤術，術後併髮胸內吻閤口瘺4例，根據患者不同臨床錶現、胸片、B超及胸部CT結果選擇治療方法，2例行手術治療，2例保守治療。對治療結果進行迴顧性分析。結果全組共髮生胸內吻閤口瘺4例，髮生率為6.1%，行保守治療2例，死亡1例。行二次手術2例，死亡1例。病死率為50%。結論①老年食管癌術前應充分評估，嚴格掌握手術適應證，加彊圍手術期管理。②胸內吻閤口瘺是食管癌術後嚴重的併髮癥和主要死亡原因。③早期診斷、恰噹選擇治療方法能提高胸內吻閤口瘺的療效。④手術方法的改進和吻閤技術的提高，有助于預防吻閤口瘺；⑤積極應用TPN支持和胃腸內營養支持是處理胸內吻閤口瘺的有效治療方法。
목적：탐토노년식관암절제술후흉내문합구루적원인분석급합리치료방법。방법회고아원자2000년1월지2009년12월대65례노년식관암행좌흉절구절제，흉내문합술，술후병발흉내문합구루4례，근거환자불동림상표현、흉편、B초급흉부CT결과선택치료방법，2례행수술치료，2례보수치료。대치료결과진행회고성분석。결과전조공발생흉내문합구루4례，발생솔위6.1%，행보수치료2례，사망1례。행이차수술2례，사망1례。병사솔위50%。결론①노년식관암술전응충분평고，엄격장악수술괄응증，가강위수술기관리。②흉내문합구루시식관암술후엄중적병발증화주요사망원인。③조기진단、흡당선택치료방법능제고흉내문합구루적료효。④수술방법적개진화문합기술적제고，유조우예방문합구루；⑤적겁응용TPN지지화위장내영양지지시처리흉내문합구루적유효치료방법。
Objective To explore the elderly esophageal carcinoma resection of intrathoracic anastomotic leakage reason analysis and reasonable treatment method. Methods Retrospectively in our hospital from 2000 January to 2009 December on 65 Elderly Patients with esophageal cancer resection of left thoracic incision, intrathoracic anastomosis, after resection of the intrathoracic anastomotic fistula in 4 cases, patients according to different clinical manifestations, chest X-ray, B ultrasound and chest CT findings choice method of treatment, 2 were treated by operation,2 cases of conservative treatment. Results Treatment were retrospectively analyzed. Results The total occurrence of intrathoracic anastomotic fistula in 4 cases, the incidence was 6.1%, conservative treatment in 2 cases,1 cases of death.Two operation in 2 cases, 1 cases of death. The mortality rate was 50%.Conclusion?①Elderly esophageal carcinoma before operation should be fully evaluated, strict operation indications, strengthen peri operation period management.②The intrathoracic anastomotic fistula after resection of esophageal cancer is a serious complication and the main cause of death.③In early diagnosis,appropriate choice of treatment method can improve the intrathoracic anastomotic fistula.④Operation method and improvement of anastomosis techniques improved, contributes to the prevention of anastomotic fistula.⑤The positive application of TPN support and enteral nutrition support treatment of intrathoracic anastomotic leakage is the effective method of treatment.
